Musings in the life of an internist, cardiologist and cardiac electrophysiologist.

Thursday, April 12, 2007

Realism versus Optimism

This morning, a realist spoke in the editorial section of the Chicago Tribune and it was refreshing. Frederick R. Lynch, a government professor at Claremont McKenna College, wrote:

Americans historically have been a death-denying people, but the aging of Baby Boomers may change all that. Actor-politician Fred Thompson, a potential GOP presidential nominee, has just announced that he is in remission from lymphoma and that he will "not be affected in any way by it." His full-speed-ahead reaction was an echo of Tony Snow's and Elizabeth Edwards' responses to cancer recurrences that continue to attract public attention and discussion -- a signal that the forever young will not go quietly into that good night.

This is in sharp contrast to the optimistic (and in my view bordering on ridiculous) ‘Chasing Life’ campaign being promulgated over at CNN by Dr. Sanjay Gupta where 'Living to be a 100’ by just changing a few lifestyle habits exemplifies the problems when personal gain and media hype trump reality. As Dr. Lynch states:

Besides testing bedrock beliefs in work and success, Boomers' lifelong faith in scientific salvation is also fading. Older Boomers are recognizing that much-anticipated magic bullets may not arrive in time. Heart and circulatory death rates have been reduced through bypass surgery, statins and behavioral change; early detection and prevention have proved effective against diabetes and some cancers; but aggressive cancers and some other lethal illnesses remain stubborn foes.

Absent scientific breakthroughs, highly educated, driven Boomers facing serious health issues are falling back upon their related faith in "management" and take-charge "empowerment." In "The Year of Magical Thinking," author Joan Didion was struck by her successful friends' confidence in their ability to control their own lives -- even life-threatening illness. "Their initial instinct was that this event could be managed. In order to manage it they needed only information ... They believed absolutely in the power of the telephone numbers they had at their fingertips, the right doctor, the major donor, and the person who could facilitate a favor." Indeed, in discussing the Edwards and Snow cases, several talk-show hosts and experts assured audiences that cancer increasingly is a "manageable disease" like other chronic conditions such as diabetes. (Contrarian Boomers invoke their generation's dictum to "get real." The late Texas political columnist Molly Ivins bluntly summarized four years of breast-cancer treatment: "First they mutilate you; then they poison you; then they burn you.")

While optimists certainly have their place, to suspect that we have perfected the formula of life misleads and misinforms patients. But then, Dr. Gupta is trying to sell his book, isn’t he? I mean, sweepstakes?

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About Me

Westby G. Fisher, MD, FACC is a board certified internist, cardiologist, and cardiac electrophysiologist (doctor specializing in heart rhythm disorders) practicing at NorthShore University HealthSystem in Evanston, IL, USA and is a Clinical Associate Professor of Medicine at University of Chicago's Pritzker School of Medicine. He entered the blog-o-sphere in November, 2005.
DISCLAIMER: The opinions expressed in this blog are strictly the those of the author(s) and should not be construed as the opinion(s) or policy(ies) of NorthShore University HealthSystem, nor recommendations for your care or anyone else's. Please seek professional guidance instead.